Drs or Lack of Drs

Does anyone have any tips for actually seeing a Dr or getting a Dr to visit a caree who can’t get to the surgery?


I’ve done the obvious in phoning up and asking but don’t get anywhere. Let me start from the beginning.

For the second time since late June early July, Nan’s legs are purpley/red and bright red in places. Sometimes they have blisters sometimes not. She retains water and we elevate and have Freusomide to combat this. Back in the summer we visited the surgery several times and several different creams were prescribed then finally a GP visited {ours as luck would have it} and said the leg was infected it’s cellulitis. She gave her some antibiotics but it didn’t do much, another GP visited and said oh it often needs more than one course and gave some more. I then rang the surgery and got a phone call back with yet another prescription. By the end of the third one it had all but gone. I spoke to the Dr and she said oh we won’t bother with another lot see what happens. It got worse and spread to the other leg so we went in and saw another Dr who gave some more antibiotics and it went away.

Last week I noticed it was back. I couldn’t get an appointment so asked for a Dr to visit. An acute practitioner came {Dr’s don’t do visits anymore} and said well it’s probably nothing but have some antibiotics as it’s the same place as last time. Nan was due a cataract op on Thur {yesterday} so as no improvement had been made I called the surgery first thing Monday and asked for an Appointment, we saw the nurse practitioner who gave us cream for Eczema. By Wednesday it was worse and had spread to both legs so I called back up and asked for a Dr to visit. Four hours later a phone call from the acute practitioner can you bring her in…no that’s why I asked for the visit groan she agrees to come out “even if I probably won’t know what it is” {then why not send someone who WILL know? Sorry running out of patients with the whole charade}. So out she comes and says hmmm it does look worse {wise to this by now I take daily photos as reference and record} I’m not sure what it is but here have some more antibiotics {we won’t discuss the losing of prescriptions it’s too much for my blood pressure}, she took some photos to show her colleagues and left. I rang the hospital no cataract op until she is infection free.

The new course of antibiotics will run out next Friday and from previous experience I fear I will be calling them up again. Oddly I can get past reception who as soon as I explain says she needs to see someone today and not wait it’s the actual Dr’s I’m having issues with. The acute practitioner has told us not to book appointments or visits on a Monday they are too busy and don’t have time. A Dr no longer does a home visit so we only ever see the same person who doesn’t have clue what it is by her own admission and most Drs we see moan about time wasting and that we shouldn’t be able to see a Dr this easy. It’s clearly a genuine problem but how can I get them to take me seriously?

Ring the Practice Manager and explain the situation.
A while ago I put a link on the forum to a booklet that GP’s organisation wrote about supporting carers. Might be worth finding and reading. (Sorry I have a room waiting to be painted, or I’d find it for you).
If that doesn’t work, ring the local CCCG and ask what service they expect the GP to provide.

It seems that the antibiotics ease the situation but don’t thoroughly treat the cellulitis completely. Perhaps your nan needs stronger IV antibiotics in hospital? That was the case with my mum’s UTIs. I’m sure you will monitor her legs. Cellulitis can become very nasty. If it doesn’t get any better and you have problems with the gp surgery, I’d be tempted to get nan to A&E.

Slightly confused what is a CCCG? I have a carers health check at the surgery next month so will raise it with them. I have in the past contacted practice manager and things improved slightly for a while. I will try that too. I hadn’t thought of A&E although I did consider out of hours GP. I just don’t understand the point of repeatidly giving the same antibiotic if it doesn’t work {they changed it eventually from Flucluxicillin to doxycyclin and that worked. Why didn’t they just give that the first time this time? Nor do I understand why send someone who doesn’t know…none of it makes any sense to me. What puts me off the trip to A&E is the wait times and having to drag toilet adaptions with no guarantees they would work…unfortunately many of the most used adaptions aren’t suitable because of fixed hips etc.

I suppose you could try 111. A few hours wait and 2-3 days in hospital might do the trick. Call 999 for an ambulance there and back. Once in the A&E the nurses there will sort out toileting. I’d consider it and wouldn’t hesitate if there was a flare up.

CCG ?

NHS England » NHS England’s Chief Executive celebrates CCG’s achievements

__

Clinical Commissioning Groups (CCGs)

Clinical Commissioning Groups (CCGs) commission most of the hospital and community NHS services in the local areas for which they are responsible.

Commissioning involves deciding what services are needed for diverse local populations, and ensuring that they are provided.

CCGs are assured by NHS England, which retains responsibility for commissioning primary care services such as GP and dental services, as well as some specialised hospital services. Many GP services are now co-commissioned with CCGs.

All GP practices now belong to a CCG, but CCGs also include other health professionals, such as nurses.

Services CCGs commission include:

most planned hospital care
rehabilitative care
urgent and emergency care (including out-of-hours)
most community health services
mental health and learning disability services.

I had no idea it could be that easy. I am really good at feeling guilty though so try my hardest not to make a fuss unless I have no choice, I am def considering that. Thank you

OH wow I had never heard of the CCG, that’s incredible thank you so much.

I had cellulitis after a knee replacement, and a friend (whose wife is a paramedic) developed it after he had a hip replacement. Apparently according to J’s wife, once you’ve had it once, you are more likely to get it again, so at the first sign of symptoms, treatment is needed.

Because mine had been misdiagnosed when I went to the pharmacy, it got worse than it should have done, and I ended up having to go to the hospital for daily antibiotic injections AND taking two lots of antibiotics at the same time!! (Fortunately our local hospital has a “Minor Injuries Unit” which is incredibly efficient, and it’s at the bottom of my road!)

I have had it once since, it’s a strange feeling that once, you know exactly what it is when you get it again. I immediately rang my GP, who asked me why I thought I had cellulitis? When I explained, he arranged for me to have an appointment the same day, confirmed my diagnosis, and then gave me antibiotics which I needed.

Your posts to others are always so caring and thoughtful. Now time to be proactive for nan!

Dont underestimate the cellulitis when you call and don’t be surprised if they pass you on to a medic over the phone. The medic might even visit. Do tell them that after so many courses of topical antibiotics, that the infection is back or never really went away. Is it throbbing, warm to touch? And how much of leg(s) is impacted. They’ll ask about your nans other conditions, her mobility and feeling in her legs, I would think.

While mum was in hospital, I saw some of the other patients’ legs, so I think it’s wise to urge caution, rather than just seeing how it goes. I gather too that if you arrive in an ambulance the patient can get an ambulance to take you home.

In my experience, the wait to be seen was often far shorter than the wait for transport home.

Let us know what transpires.

Have you tried contacting the District Nurse team? I feel sure you would get somewhere faster through them if the situation warrants it, (which I don’t doubt it does).

I think the doctors need to refer the district nurses. Once referred, you can call them directly, I believe?

I think the doctors need to refer the district nurses. Once referred, you can call them directly.

If situation gets worse you can still call 999 or 111, or the gp.

Hmmm the District Nurse idea is a good one, I am going to ring and ask for referral, Nan has retained fluid and for several years had dry skin until the cream was changed and I nagged any carers who did the shower to put it on very liberally.

If it’s easy to get more than once then that makes me feel a little easier it’s just how I convince the Dr’s/practitioners that she needs treatment sooner rather than later.

Aww thank you, I am aware most people have it far harder than I do and I try not to moan or complain. I am rather pleased I come across as caring and supportive though because I do try. I am going to request regular contact with the District Nurses and perhaps a flag put on Nan’s records for antibiotics with the start of a cellulitis infection. I also need to find out if there is a way I can get the script quicker than 36 hours after seeing/speaking to someone.

Thank you so, so much for helping I REALLY appreciate it.

Not wanting to scare anyone, but if the cellulitis worsens, per nhs online info, it can lead to sepsis - very serious indeed.

P.S. You’ve got it worse enough! Don’t hesitate in asking for medical help, 111 atleast. And keep on posting here please!

In most cases, the doctors can send prescriptions to most pharmacies electronically.

Cellulitis is very nasty, painful, my caree has diabetes 2 and gets cellulitis regularly. She feels very rough ill, doesn’t feel like eating, start of the infection, then the rash starts going up your legs.

Her GP has given a prescription in advance, as antibiotics are needed as soon as possible, waiting for a doctors appointment then having to run to the chemist means the cellulitis will get worse.
If your doctors could do that it would save a lot of time and pain.

It needs discussing with someone the district nurses or the G.P. to get on top of the situation, your nan could end up in hospital if it gets worse.

Send it electronically oh that made me giggle, I’m surprised they even print a prescription let alone send it electronically. Even repeats are done on paper. They have to find someone to sign a script then put it in a basket to be collected from the signers room to go to reception where the chemist must fetch it, not us but the chemist of your choice only. Trouble is none of the chemists go daily it’s weekly at best so your forever waiting…the receptionists are now offering to see if it’s left waiting for the chemist to collect and giving it to you.

I am going to make an apt with a GP, I’ll probably have to wait a few weeks but it will be worth it just to see if something can be done to stop this. I’m not in the habit of phoning or booking appointments unless I have no choice and at least one receptionist is aware of how I try and I dismiss it as not urgent and will book an urgent apt. I am currently making a list of questions so that I can go armed with what I want to know.

I really hope nobody else has it this complicated as it’s headache inducing if nothing else.

Not only headache inducing I’m afraid. My neighbour with diabetes and cellulitis had part of his leg amputated. Severe cases can lead to sepsis and death. That’s why it is so important to keep getting the right treatment, sad to say.

I hate to say it but I doubt the Dr’s would learn even if that happened, they just don’t seem to be at all interested, it’s too much of an inconvience to not only go to work but see patients too.

I have always found that surprising. Some specialists puzzle me. Do they seriously think I want to be there waiting around? Is there any way to complain or file a report? A email might also work wonders here. It is not all about the money.